Objectives: Increased use of long-acting reversible contraception (LARC) could significantly reduce unintended pregnancies, but less than 10% of US women currently use IUDs or implants. A critically understudied aspect of LARC methods and contraception more generally is their sexual acceptability, or their effects on women’s sexuality, which could influence continuation rates and marketing efforts. Methods: We recruited 49 new-start copper IUD users, 79 levonorgestrel IUD users, and 60 contraceptive implants users from family planning clinics in Salt Lake City. We assessed a variety of sexual acceptability outcomes among these 188 women across three time periods. Results: After both 1 and 3 months of use, new LARC users did not report sexual functioning or sexual satisfaction scores that differed significantly from baseline. However, participants were significantly more likely to report subjective improvements to their sexual lives. At 1 month, 38% of women indicated their new method had improved their sex life in the last four weeks, compared to 13% reporting their method had made their sex life worse (p<0.05). By 3 months, 40% of women reported improvements. Sexual detractions were largely accounted for by reports of increased menstrual bleeding and cramping. Conclusion: Findings suggest that 1) women’s perceptions of whether their method is affecting their sexuality may be more important than measures of sexual functioning, 2) IUDs and implants show potential for improving sexuality by way of enhancing women’s sense of security against unintended pregnancy, and 3) increases in menstrual bleeding and cramping were associated with women’s sexual dislike of their method.